Individual provider Active NPI

Heidi Louise Moran, MLADC

  • Addiction (Substance Use Disorder) Counselor
  • Dover, NH
National Provider Identifier
1780940890
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
MLADC 0572 Issued in NH
Practice address
272 County Farm Road
Dover, NH 03820-6026
Phone
(603) 516-8164
Fax
(603) 749-3983
NPI assigned
Apr 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP 60211219 WA
Addiction (Substance Use Disorder) Counselor 101YA0400X MLADC 0572 NH Primary

Addresses

Primary practice location

272 County Farm Road
Dover, NH 03820-6026

Mailing address

272 County Farm Road
Dover, NH 03820-6026
Phone (603) 516-8164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MLADC 0572NHMDAddiction (Substance Use Disorder) Counselor
CP 60211219WAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388620800000",
    "number": "1780940890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 COUNTY FARM ROAD",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038206026",
            "telephone_number": "603-516-8164",
            "fax_number": "603-749-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 COUNTY FARM ROAD",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038206026",
            "telephone_number": "603-516-8164",
            "fax_number": "603-749-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "HEIDI",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "MLADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2014-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP 60211219",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "MLADC 0572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.